See discussions, stats, and author profiles for this publication at: https://www.researchgate.

net/publication/327686722

Recent interocclusal record material for prosthetic rehabilitation - A

literature review

Article  in  Drug Invention Today · July 2018

CITATIONS READS

0 3,214

3 authors, including:

Ashish R Jain
Tamil Nadu Dr. M.G.R. Medical University
209 PUBLICATIONS   340 CITATIONS   

SEE PROFILE

All content following this page was uploaded by Ashish R Jain on 08 February 2019.

The user has requested enhancement of the downloaded file.

 Review Article

Recent interocclusal record material for prosthetic

rehabilitation - A literature review
B. Deepthi1, V Rakshagan2, Ashish R. Jain2*

ABSTRACT

Accurate interocclusal record minimizes the need for intraoral adjustments during prosthesis insertion. They are essential in
providing high-quality restoration and reducing treatment time and cost. The success of the prosthetic rehabilitation treatment
depends on several aspects related to the precise mounting of casts in the articulator for full mouth situations. This article
helps us in understanding the various materials and techniques for prosthetic rehabilitation.

INTRODUCTION IDEAL
KEY WORDS: Anterior stop, Interocclusal records, Interocclusal REQUIREMENTS
recording techniques, OF
Lucia jig, Occlusion

In general, in dentistry, it is equally important to examine INTEROCCLUSAL RECORD

the occlusion, as well as record, store, and transfer MATERIALS[1-3]
the relationship from the mouth.[1] The interocclusal
1. Limited resistance before setting to avoid displacing
registration material records the occlusal relationship
the teeth of mandible during closure.
between the natural and/or artificial teeth for planning
2. Rigid or resilient after setting.
the prosthesis for construction of removable and fixed
3. Minimal dimension changes after setting.
partial dentures. Interocclusal records are the maxilla
4. Accurate record of the incisal and occlusal surface
mandibular records that are used to transfer interarch
of teeth.
relationships from the mouth to an articulator.
5. Easy to manipulate.
Accurate interocclusal record minimizes the need for
6. No adverse effects on the tissues involved in
intraoral adjustments during prosthesis insertion. They
recording procedure.
are essential in providing high-quality restoration and
7. The interocclusal record is verifiable.
reducing treatment time and cost.[2] The success of the
prosthetic rehabilitation treatment depends on several
aspects related to the precise mounting of casts in the
TYPES OF INTEROCCLUSAL
articulator.[3] Over the years, various materials and RECORD MATERIALS [Figure 1]
methods have been used to detect occlusal contact.
• Alginate impression material.
The main challenges faced were achieving occlusal • Zinc oxide eugenol paste.
markings over some restorations such as gold, metal • Corrected wax.
alloys, and ceramics and on moist occlusal surfaces. • Metalized wax.
Patterns of tooth contact and properties of material • Elastomers.
and method used to record the tooth contacts are very • Impression plaster.
valuable for an accurate examination of occlusion in • Acrylic resin.
prosthodontic treatment. • T-scan.
• Pressure-sensitive films.
Access this article online • Typewriter ribbon.
Website: jprsolutions.info ISSN: 0975-7619
• Transparent acetate sheet.
• Occlusion sonography.

1
Department of Prosthodontics and Implant Dentistry, Saveetha Dental College, Saveetha University, Chennai, Tamil Nadu,
India, 2Department of Prosthodontics, Saveetha Dental College and Hospitals, Saveetha University, Chennai, Tamil Nadu,
India

*Corresponding author: Dr.  Ashish R. Jain, Department of Prosthodontics, Saveetha Dental College and Hospital,
Saveetha University, Ponamalle High Road, Chennai  -  600  127, Tamil Nadu, India. Phone: +91-9884233423.
E-mail: dr.ashishjain_r@yahoo.com

Received on: 22-03-2018; Revised on: 27-04-2018; Accepted on: 30-05-2018

2004 Drug Invention Today | Vol 10 • Issue 10 • 2018

 B. Deepthi, et al.
ALGINATE IMPRESSION
MATERIAL
Korioth reported on the number and location of
occlusal contacts in intercuspal position using alginate
impression material.[4] A technique suggested and used
by Ingervall, using indexes of alginate (irreversible
hydrocolloid) impression material were applied to
record the number and location of posterior occlusal
tooth contacts including canines. The selected subjects
were asked to rest their backs and heads on a reclined
dental chair (approximately 30° to the floor). After
spatulation, the impression material was applied to the
occlusal surfaces of all lower canines, premolars, and
molars on both sides. Subjects were instructed to close
the mouth gently and occlude the teeth together with
moderate pressure until the impression material was
set. Impressions were made on the same day. After
their careful removal, the left and right indexes were
examined against light, and the number and location of
perforations were registered as occlusal tooth contacts
for each subject.[2,3]
MODELLING WAX
It is the most versatile and most commonly used
interocclusal recording material. The reason for its
versatility is its easy manipulation. On heating, it
softens uniformly and remains same for an adequate
working time. However, it is dimensionally inaccurate
interocclusal recording material as it has a high
coefficient of thermal expansion and high resistance
to closure. Distortion of wax is also very common
due to release of internal stresses, thus, leading to
inaccuracies in the record. Therefore, it has been
classified as the most inaccurate material among the
interocclusal records studied.[3,4]
ZINC OXIDE EUGENOL PASTE
It is generally used as interocclusal recording
material. Due to the fluidity of paste before setting,
it offers minimal resistance with mandibular closure
and becomes rigid after it sets finally. However,
Figure 1: Represents the various interocclusal record materials
Drug Invention Today | Vol 10 • Issue 10 • 2018
zinc oxide eugenol paste has a lengthy setting time,
significant brittleness; they stick to the teeth and have
unreliability to reuse. As it sets by chelation reaction,
the by-products formed may undergo evaporation,
leading to dimensional change. Vital portions of
the record can be lost through breakage on removal
from the mouth. Once zinc oxide eugenol record has
been used to mount the casts, it is rarely used again.
Unless trimmed, flash around the teeth can prevent the
accurate seating of casts. Thus, it is advisable to use a
minimal amount of zinc oxide eugenol to avoid excess
flash. Therefore, zinc oxide eugenol was added to wax
impression in a very thin layer to improve poor detail
transfer and displacement of wax.[4,6]
CORRECTED WAX
In corrected wax interocclusal recording material,
interocclusal record made with wax is corrected with
zinc oxide eugenol material. It improves the detailed
recording and displacement of wax, but it increases
the vertical dimension. While making record with
corrected wax, they used double sheet of the base
plate wax and the record is made. After the removal
of record from mouth, thin layer of zinc oxide eugenol
was applied over the wax record and placed intraorally
until material is hardened.
METALIZED WAX
The metalized wax wafers (aluminum particles) are
found to be much more accurate than non-metalized
wax as the addition of metal particles (aluminum) to
the modeling wax make it more conductive which
may lead to increase in the accuracy of the record.[6]
ELASTOMERS
Elastomers are the most dimensionally stable
materials till yet. Elastomers as interocclusal record
materials consistently yielded the least error among the
materials studied. They are easy to manipulate and offer
little or no resistance to closure, set to a consistency
that makes them easy to trim without distortion, and
accurately reproduce tooth details. Furthermore, among
2005
 B. Deepthi, et al.
Figure 2: Represents advantages and disadvantages of the materials
the elastomers, addition silicones exhibit least amount of
distortion. The excellent dimensional stability of addition
silicones is attributed to the fact that it sets by addition
polymerization reaction. Therefore, no by-products and
no loss of volatiles occur in addition silicones. Accuracy,
minimal resistance to closure, and easy manipulation are
the main advantages of addition silicones as interocclusal
recording material. However, its major disadvantage is
that any compressive force exerted on these materials
during mounting procedures may cause inaccuracies
during mounting of the casts. Spring action found in these
materials may cause inaccuracies during mounting of the
casts. The spring action found in these materials caused
the articulated cast to open in centric relation position.
Thus, the records should be trimmed and carefully seated
over the occlusal surface to minimize the negative spring
action [Figure 2].[4,6,7]
POLYETHER ELASTOMER
Polyether interocclusal registration material consists
of the basic impression material augmented by
plasticizers and fillers. The advantages of this material
as an interocclusal registration material are accuracy,
stability after polymerization and during storage,
fluidity, and minimal resistance to closure, can be used
without a carrier. Disadvantages are that resiliency and
accuracy may exceed the accuracy of the plaster casts.
Both of these factors can interfere with the placement
of the plaster cast into the recording medium during
mounting procedures. The records are trimmed to
remove excess material and preserve only the teeth
indentations, avoiding distortions.[6,8]
IMPRESSION PLASTER
Impression plaster is basically plaster of Paris with
modifiers. Modifiers accelerate setting time and
decrease setting expansion. Records of impression
2006
plaster are accurate, rigid after setting, and do not
distort with extended storage. It is difficult to handle
because the material is fluid and unmanageable before
setting. The final interocclusal record is brittle.[3,5,9]
ACRYLIC RESIN
The most frequent application of acrylic resins for
interocclusal records is in the fabrication of single stop
centric occlusion records. Acrylic resin is both accurate
and rigid after setting.[2,5] Disadvantages of acrylic
resin as an interocclusal registration material include
dimensional instability due to continued polymerization
resulting in shrinkage; rigidity of the material can damage
plaster cast and dies during mounting on the articulator.
TECHNIQUES USED FOR
INTEROCCLUSAL RECORDS
Dawson’s Technique
He used bimanual manipulation to guide the mandible
to centric relation [Figure 3].[10]
a. Wax bite record: A brittle hard wax is used for this
technique. Wax is softened and placed against the
upper arch to indent it. The mandible is manipulated
to CR and patient closes into wax. Keep upward
loading compression on the condyles as the patient
closes; otherwise, the patient may protrude the jaw.
There should be no impingement into soft tissues.
b. Anterior stop technique: When the mandible is
closed, the lower incisors strike against a stop that is
precisely fitted against the upper incisors [Figure 4].
The stop should be thin enough so that the first
point of tooth contact barely misses but under no
circumstances should any posterior tooth be allowed
to contact when the anterior stop is in place. A firm
setting bite registration paste is injected between
the posterior teeth and allowed to set.
Drug Invention Today | Vol 10 • Issue 6 • 2018
 B. Deepthi, et al.
Figure 3: Describes various techniques
Figure 4: Represents anterior stop technique
Figure 5: Represents triple tray technique
Figure 6: Represents wide enamel cone
Triple Tray Technique
A plastic registration frame (triple bite impression
tray) is used in this method to carry the interocclusal
registration material [Figure 5].[11] The frame is tried
in the mouth on the side with the prepared teeth. Trim
away the film that covered the unprepared teeth. Apply
the bite registration material evenly on to both top and
bottom of the frame and insert the tray in the mouth,
Drug Invention Today | Vol 10 • Issue 10 • 2018
centering the loaded portion over the prepared tooth
or teeth. Cut excess material that extends over the
unprepared teeth adjacent to preparation. Remove the
excess thickness of the record so that only the imprint
of cusp tip should remain. The part of the record facial
to the mandibular buccal cusp tips is cut off all the
way through the posterior member of the frame, and
the facial segment of the record is discarded.
Enamel Island Method[12,13]
This method preserves a centric stop on an abutment
as an aid when making interocclusal record [Figure 6].
Interocclusal Registration Technique with Vacuum
Formed Matrix[14]
On the teeth opposing the planned abutments, a 0.20-
inch vacuum-formed matrix is made. Prepare the
opposing teeth abutments and make the definitive
impression in the material of choice. Place the matrix
on the opposing dentition and ensure that it clears the
opposing occlusion completely. Add autopolymerizing
acrylic resin to the surface of the matrix to record a
cusp of the preparation in maximum intercuspation or
centric occlusion
Intraoral Resin Coping[11,15]
Select a preformed polyethylene core former of
appropriate size [Figure 7].
• Fill the polyethylene matrix (about one-third) with
the resin mixture and place it over the prepared
structure.
• Lubricate occlusal surfaces of antagonistic teeth
with petroleum jelly. Add small quantities of low
shrinkage autopolymerizing acrylic resin to the
occlusal surface of the coping and ask the patient
to close into maximum intercuspation.
• Keep teeth in contact until complete polymerization.
After polymerization, the record is trimmed to
remove flash, leaving the impression of the opposing
cusp tips intact.
2007
 B. Deepthi, et al.
RECENT INTEROCCLUSAL
RECORD MATERIALS
T-Scan[6,16]
In this system, electrical resistance develops with
the applied force. When the patient occludes on
the sensor, the particles come together in the force
applied areas, diminishing the electrical resistance.
The u-shaped sensor foil is 60 microns thick, consists
of an X-Y coordinate system with 1500 sensitive
receptor points made of conductive ink, and is
subject to elastic deformation. When an operator
properly uses this technology, mark size, mark
color depth, donut-shaped halo contacts, as well as
other color and mark appearance characteristics are
ignored as force indicators and used only as contact
locators. The first occlusal contact that results when
the mandible is closed on a correct centric relation
axis is known as the centric relation prematurity.
This procedure (T-scan) combines bimanual
manipulation with the simultaneous recording of
the sequence of resultant tooth contacts using a
computerized occlusal analysis system. Several
researchers have reported that the sensors do not
have the same accuracy among themselves and have
fewer contacts than conventional methods such as
articulating papers. However, it has been shown that
the pressure-sensitive film method is not as accurate
as the silk ribbon and detecting occlusal contacts. For
this reason, it appears that the clinical applicability
of the T-scan system is limited. The sensitivity of
the T-scan sensors has been reported to decrease or
disappear when the sensors are used more than once.
Figure 7: Represents resin coping
2008
Mizui et al. measured the timing and force of occlusal
contacts in both 60 normal subjects and 5 patients with
an unspecified craniomandibular disorder (CMD) using
the T-scan system. They reported that in the normal
subjects the timing and force of occlusal contacts were
symmetrical and the center of effort was located in the
first molar region. For patients with CMD, the timing
and force of occlusal contacts were asymmetric, and
the center of effort was not always located in the first
molar region, as determined with the T-scan system.
PRESSURE-SENSITIVE FILMS
A newer but essentially similar device has been
introduced (Dental Prescale, Fuji Film, Tokyo, Japan).
This device also records the location and force of contacts
with the force-sensitive film. Hattori et al. evaluated the
reliability of this device for occlusal force measurement
both on a subject and on casts. They reported the linear
relationship between the applied and measured loads.
The primary limitation of the contact sensor and the
pressure-sensitive film device is that the recording
medium is far too thick and results in heavier contacts
on the posterior teeth than the anterior teeth. Further, this
sensor thickness disturbs the persons finding attempts
to close into the intercuspal position. This is because
a study on interocclusal thickness discrimination has
shown that aluminum foil as thin a 20 µm can give bite-
disturbing proprioceptive information to a subject.[17]
TYPEWRITER RIBBON
Ziebert and Donegan used typewriter ribbon to
mark supracontacts or occlusal interferences in their
Drug Invention Today | Vol 10 • Issue 6 • 2018
 B. Deepthi, et al.
patients for occlusal adjustments. Interferences were
marked with typewriter ribbon and contacts verified
with 0.00l-inch shim stock. The adjustment procedure
basically that of Schuyler following the M. U.D.L.
rule for the retruded position, the B.U.L.L. rule for the
retruded position, the B.U.L.L rule for the working
movement, and the D.U.M.L. rule for protrusion.
Non-working interferences were eliminated so as to
maintain at least one centric stop on each tooth.
TRANSPARENT ACETATE SHEET
It is based on occlusal sketch technique that aimed
to provide a simple and reliable means of recording
and transferring information about the location of
marked occlusal contacts. The authors marked static
occlusal contacts of 20 sets of models were recorded
in a pseudoclinical situation, by three dentists and
in addition by one dentist on two occasions using
a schematic representation of the dental arch - the
“occlusal sketch.” As per Daves et al., the sketch
consists of an acetate sheet on which a schematic
representation of the teeth is drawn, including the
occlusal surfaces of the posterior teeth, the palatal
surfaces of the maxillary anterior teeth, and the labial
surfaces of the mandibular anterior teeth. The same
authors concluded that this technique demonstrated
interoperator and intraoperator reliability in recording
occlusal contacts in vitro. The aim of the occlusal
sketch technique is to provide a simple and reliable
means of recording and transferring information about
the location of marked occlusal contacts. It may also
be used by the technicians to verify occlusal contacts
when articulating casts and fabricating indirect
restorations.[17,18]
OCCLUSION SONOGRAPHY
The first studies to detect tooth contact by the sounds
generated during mouth closure began to appear in
the literature in the 1960s, one commercial device
was produced in the mid-1980s called “Dental Sound
Checker” (Yoshida Dental Trade Distributing Co.,
Ltd., Tokyo, Japan). The device, based on the principles
put forth by Watt, was developed to evaluate occlusal
contact sound patterns during closure in an attempt to
detect occlusal disturbances. Klifune et al. measured
the duration of the occlusal sound in a single subject
before and after occlusal adjustment and reported a
clear decrease in the duration of the occlusal sound
with adjustment. The relationship between graphic
Drug Invention Today | Vol 10 • Issue 10 • 2018
View publication stats
records of sounds of occlusion and the types of tooth
contact which produced them was investigated by the
authors by filming various types of occlusal contacts
with a Fastax rotating prism camera at approximately
1000 frames per second the sliding of the teeth over
each other was seen on the films as low amplitude
vibrations, and the tooth impacts as high amplitude
one.[19]
REFERENCES
1. Combe EC. Notes on Dental Materials. 5th  ed. Edinburgh:
Churchill Livingstone; 1986
2. Craig RG. Dental Materials Properties and Manipulations.
4th ed. St. Louis: Mosby and Company; 1987.
3. Skurnik H. Accurate interocclusal records. J  Prosthet Dent
1969;21:154-65.
4. Korioth TW. Number and location of occlusal contacts in
intercuspal position. J Prosthet Dent 1990;64:206-10.
5. Nandal S, Shekhawat H, Ghalaut P. Inter-occlusal record
materials used in prosthodontic rehabilitations. Int J Enhanced
Res Med Dent Care 2014;1:8-12.
6. Freilich MA, Altieri JV, Wahle JJ. Principles for selecting
interocclusal records for articulation of dentate and partially
dentate casts. J Prosthet Dent 1992;68:361-7.
7. Kerstein RB, Wilkerson DW. Locating the centric relation
prematurity with a computerized occlusal analysis system.
Compend Contin Educ Dent 2001;22:525-8, 530, 532 passim.
8. Squier RS. Jaw relation records for fixed prosthodontics. Dent
Clin North Am 2004;48:vii, 471-86.
9. Lassila V. Comparison of five interocclusal recording materials.
J Prosthet Dent 1986;55:215-8.
10. Dawson PE. Functional Occlusion: From TMJ to Smile Design.
St. Louis: Mosby (Elsevier); 2007. p. 93-7.
11. Shillinburg HT, Hobo S. Fundamentals of Fixed Prosthodontics.
3rd ed. Chicago: Quintessence Books; 2002. p. 41-3.
12. William FP, David L. Tylman’s Theory and Practice of Fixed
Prosthodontics. 8th  ed. St. Louis: Medico Dental Publishing;
2000. p. 275.
13. Sato Y, Hosokawa R, Tsuga K, Kubo T. Creating a vertical stop
for interocclusal records. J Prosthet Dent 2000;83:582-5.
14. Curtis SR. Interocclusal registration technique with a vacuum-
formed matrix. J Prosthet Dent 2003;90:308-9.
15. Stamoulis K. Intraoral acrylic resin coping fabrication for
making interocclusal records. J Prosthodont 2009;18:184-7.
16. Gazit E, Fitzig S, Lieberman MA. Reproducibility of occlusal
marking techniques. J Prosthet Dent 1986;55:505-9.
17. Hattori Y, Okugawa H, Watanabe M. Occlusal force
measurement using dental prescale. J  Jpn Prosthodont Soc
1994;38:835-41.
18. Davies SJ, Gray RJ, Al-Ani MZ, Sloan P, Worthington H.
Inter-and intra-operator reliability of the recording of occlusal
contacts using ‘occlusal sketch’ acetate technique. Br Dent J
2002;193:397-400.
19. Watt DM. Recording the sounds of tooth contact: A diagnostic
technique for evaluation of occlusal disturbances. Int Dent J
1969;19:221-38.
Source of support: Nil; Conflict of interest: None Declared
2009